Provider Demographics
NPI:1780167072
Name:MAKI DROLLINGER DC, PLLC
Entity type:Organization
Organization Name:MAKI DROLLINGER DC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:MAKI
Authorized Official - Middle Name:
Authorized Official - Last Name:DROLLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-591-9251
Mailing Address - Street 1:10957 S OQUIRRH LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009-7741
Mailing Address - Country:US
Mailing Address - Phone:310-591-2951
Mailing Address - Fax:
Practice Address - Street 1:248 E WINCHESTER ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7305
Practice Address - Country:US
Practice Address - Phone:310-591-9251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty